Top 7 Frequently Asked Questions about Implantation Bleeding

Introduction

Is it your imagination, or are you more tired than usual? Are you going to the bathroom more often, or are you feeling nauseous every morning? When trying to get pregnant, even the smallest changes can make you feel hopeful for a positive result on your pregnancy test.

While testing positive in the early stages of pregnancy, at 5 DPO (days past ovulation) is rare, there are other signs you could look out for. Unfortunately, many pregnancy symptoms may overlap with what you would generally feel just before your periods, making it hard to know the difference between them. One such symptom is implantation bleeding.

Around a third of pregnant women [1] generally experience implantation bleeding. This is often accompanied by cramps. In this article, we answer seven of the most common questions many women have about implantation bleeding, implantation cramps, and the other signs of early pregnancy.

• What is implantation bleeding?
• When does implantation bleeding occur?
• What is the difference between implantation bleeding and menstrual bleeding?
• What are implantation cramps?
• What other signs of early pregnancy could occur with implantation bleeding?
• What are the other causes of bleeding in early pregnancy?
• Should you take a pregnancy test during implantation bleeding?

What is implantation bleeding?

During intercourse, the male sperm enters the vagina and the uterus to make its way to the fallopian tubes, where a viable egg, released from the ovaryvary after ovulation, is ready to meet it. This is when fertilizationfertilisation takes place. The fertilizedfertilised egg or the embryo then travels from the tubes toward the uterus, where it attaches to the uterine wall to grow and mature into a fetus, in a process called implantation. As the egg burrows into the uterine lining, it may break a few blood vessels, causing small amounts of blood to come through the vagina. This is known as implantation bleeding.

When does implantation bleeding occur?

You ovulate 12-14 days before your nextIf you have a regular 28-day cycle, you usually ovulate on day 14 of your cycle.[2] This means implantation may occur [3]  between 17 to 26 days after the first day of your last period.  The fertilizedfertilised egg attaches to the uterine wall of the uterus anytime between 6 to 10 days after ovulation (10 DPO).

As soon as the embryo implants itself into the thickened uterine lining, it causes the lining to slough off, leading to implantation bleeding. Once implantation occurs, your body releases human chorionic gonadotropin (hCG) [4] to support the pregnancy. Urine pregnancy tests or blood tests for pregnancy check for HhCG hormone levels to provide a positive result.

What is the difference between implantation bleeding and menstrual bleeding?

Implantation bleeding is a very early symptom of pregnancy. Its timing may coincide with the beginning of your menstrual cycle. So,  it can be easy to mistake implantation bleeding for a regular period. Here are a few simple ways to differentiate the two.

What are implantation cramps?

Implantation cramps can signify early pregnancy, but many women have trouble differentiating them from menstrual cramps.

As the fertilizedfertilised egg implants into the uterine lining, it activates hormones called prostaglandins, which trigger the smooth muscles of the uterus to contract. This is felt as painful cramps.

Implantation bleeding and cramps may not always occur together. Many women experience one but not the other, while some women don’t experience either one.

Since they are very similar, the best way to tell the difference between menstrual and implantation cramps is to wait and see if you get your period soon after.

What are other signs of early pregnancy that could occur with implantation bleeding?

Implantation bleeding and other signs of early pregnancy may appear within the first 10 days post ovulation or 10 DPO. These are usually due to the effect of progesterone (“the pregnancy hormone”) on your body.

• Mood swings
• Tender, swollen breasts and tender nipples
• Fatigue
• Abdominal bloating
• Headaches
• Episodes of nausea or vomiting
• Food aversions or cravings
• Frequent passing of urine
• Constipation
• Stuffy nose

What are the other causes of bleeding in early pregnancy?

While implantation bleeding may be one of the causes of bleeding during early pregnancy, it is essential to rule out other conditions that could be harmful to either you or your baby. A few reasons could be:

• Sexual intercourse, because the cervix is very tender and sensitive at this time.
• Ectopic pregnancy, where the embryo implants and develops somewhere outside the uterus, such as the fallopianuterine tubes, abdominal cavity, ovaries, or cervix
• Threatened abortion where the embryo is still inside the uterus, but the pregnancy may be in danger due to an infection, certain medicines, or physical trauma.
• Complete miscarriage
• Molar pregnancy, which is a rare pregnancy complication where an abnormal mass of cells develops inside the uterine cavity instead of the baby.
• Inflammation or infections of the cervix or vagina or cervix, including sexually transmitted infections such as herpes, chlamydia, or gonorrhoea.

Should you take a pregnancy test during implantation bleeding?

While you can take a pregnancy test during implantation bleeding, there is a chance that you may get a false negative. This is because the pregnancy hormone human chorionic gonadotropin (or (hCG), which needs to be detected by pregnancy tests for a positive result, is only produced in your body AFTER the embryo digs into the uterine wall causing implantation bleeds.

If you take the test too early, there will be lower levels of hCG in your system, which may not be detectable by the pregnancy test. To get a more accurate result, it may be best to wait until after the first day of your missed period.

Conclusion

Implantation bleeding may be overlooked as an early sign of pregnancy because of its similarities to a regular period. If you are looking forward to being pregnant, signs of bleeding can be scary because of the risk of miscarriage. On the other hand, these blood drops could also signify that you’re about to start your exciting journey to motherhood!

Summary

1. As a fertilizedfertilised egg burrows into the uterine lining, it may break a few blood vessels, causing small amounts of blood to come through the vagina. This is known as implantation bleeding, marking the beginning of pregnancy.
2. Ovulation occurs 12-14 days before your next cycle. If you have a regular 28-day cycle, you usually ovulate on day 14 of your cycle.[2] This means implantation may occur [3]  between 17 to 26 days after the first day of your last period. The fertilizedfertilised egg attaches to the wall of the uterus anytime between 6 to 10 days after ovulation
3. Implantation bleeding is a very early symptom of pregnancy. Its timing may coincide with the beginning of your menstrual cycle. So,  it can be easy to mistake implantation bleeding for a regular period
4. As the fertilized-fertilised egg implants itself into the uterine lining, it activates hormones called prostaglandins, which trigger the smooth muscles of the uterus to contract. This is felt as painful cramps.
5. Implantation bleeding may occur along with other early pregnancy signs within the first 10 days post ovulation or 10 DPO. These are usually due to the effect of progesterone (“the pregnancy hormone”) on your body.
6. While implantation bleeding may be one of the causes of bleeding during early pregnancy, it is important to rule out other conditions that could be harmful to either you or your baby.
7. While you can take a pregnancy test during implantation bleeding, there is a chance that you may get a false negative. To get a more accurate result, it may be best to wait until after the first day of your missed period.

References: 

1. https://americanpregnancy.org/pregnancy-symptoms/what-is-implantation-bleeding/
2. https://www.ncbi.nlm.nih.gov/books/NBK500020/
3. https://www.medicinenet.com/can_take_pregnancy_test_when_implantation_bleeding/article.htm
4. https://www.frontiersin.org/articles/10.3389/fimmu.2020.00343/full
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422651/
6. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign